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Lack of relevant data has continued to militate against the development of policy and practice toward identification and treatment of alcohol/substance abuse among adolescents coming in contact with the juvenile justice system in Nigeria. This study aims to provide such data, including its policy/practice implications.
Methods.
One hundred and seventy eight (178) adolescents, who are representative of adolescents within the youth correctional services of Lagos jurisdiction, were interviewed using the alcohol and substance abuse section of the Kiddies’ Schedule for Affective Disorders and Schizophrenia.
Results.
The lifetime prevalence rate of abuse of/dependence on any of alcohol or other substances was 22.5% (alcohol, 12.3%; illicit substance, 17.9%). Males were overrepresented among those with any substance use disorder, with gendered prevalence rate as high as 35%. Having had a lived-experience of being a street-child was the single most significant independent factor (Odds ratio (OR), 8.4; p = 0.007) associated with lifetime alcohol substance use disorder.
Conclusions.
Substance use disorder is highly prevalent among adolescents within the juvenile justice systems in Lagos Nigeria. There is need for deliberate incorporation of alcohol and substance abuse screening and intervention as part of individual care plan in youth correctional facilities in Nigeria. Practical steps toward achieving this were drawn from local reality and international best practices.
Data are progressively accumulating regarding the transition to adult services.
Methods
A comprehensive search using the MEDLINE, Embase, PsycINFO, and Cochrane databases up until 16 March 2015 was conducted in order to summarize recent evidence on the transition from child to adult mental health services for patients with mental disorders. Authors extracted data and assessed study quality independently.
Results
The main findings of the 33 included studies were discussed taking into consideration four aspects: experiences of patients, carers, and clinicians, accounts of transition, current services models and protocols, and outcomes of transition. Of the 33 studies, 17 focused on a specific mental disorder: seven on attention deficit hyperactivity disorder, four on intellectual disability, three on eating disorders, two on serious emotional disorders and one on autism spectrum disorder. An attempt was also made to integrate the studies’ conclusions in order to improve transitional care.
Conclusions
The review reveals an evident need for longitudinal, controlled, health services research to identify and evaluate optimal service models with systematic and seamless transition protocols for patients with mental disorders requiring continuity of care into adult mental services.
This chapter discusses the challenges and opportunities associated with building a practice for child mental health services in Liberia. For children and youth in post-conflict settings such as Liberia, mental health services are almost non-existent, despite the greater need. The chapter focuses on the research on child and adolescent mental health prevalence and the treatment gap for children and youth. The 2009 National Mental Health Policy provided a framework for children's mental health policy and practice. John F. Kennedy Medical Center (JFKMC) is the only tertiary care referral hospital in Liberia. The chapter outlines how services for children are currently organized at Grant Hospital, with outpatient services at JFKMC. A second source of specialty mental health in the JFKMC system is housed in its main ambulatory service. In conjunction with partners, JFKMC launched a child and maternal mental health consultation service in early 2012.
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